to be cross my ds has measles because other parents didn't vaccinate their children

[snickersnack]

He's 11 months old, poor little thing . Fortunately he's going to be ok - he got off quite lightly, I think - but it was scary and he was really poorly for a day or so. Spent 10 hours in A&E yesterday while he had chest x-rays, blood tests, IV fluids etc. Now we're just waiting to see if his sister,who's 2, gets it - she's had one dose of MMR already so fingers crossed she's immune.

We live in an area where immunisation rates are among the lowest in the country. Now I have to go and tell all parents of the other babies he's met recently that their children might be at risk as well...

"single jabs expose children to a longer period without immunity to these diseases"

Several months. Are we haggling over just a couple of months?

There is a (real or perceived) risk around MMR, and as a result, a significant number of parents are refusing to vaccinate their children.

Assuming their goal is to maximise immunisation rates, the rational strategy for UK government should be to offer single vaccines. Surely, several more months without immunity is a good trade-off against higher vaccination rates.

Unless, of course, their goal is to achieve maximum possible immunisation rates without increasing cost (of more doctor's visits, more vaccines, etc). This would explain the current (1) denial that there is any reason for concern, (2) campaign of Straw Man arguments, namely, repeated diffusion of experiments that do not address the original concern (Which children will be negatively affected by MMR?) but are nonetheless presented as having discredited it, and (3) refusal to offer single vaccines.

Recent published work seems to be showing that mumps for example is more effective as a single vaccine than in the MMR. So there could be more danger of exposure from MMR anyway.

The dept of health told me in 2001 (or maybe 2000 can't be bothered to look for the letter) that there was no significant decrease in the MMR anyway, and that my perception that parents wanted the choice of singles was wrong. They can't have it both ways. Either parents are rejecting MMR (but how many leave their children completely unvaccinated- the majority give singles- never reflected in the 'we're due a measles outbreak' shrieking headlines) or they're not and once again they can drop the 'threat of measles outbreak' headlines.

The most recent study (last week in BMJ) showed 90%uptake of the MMR, with 5% having no alternative vaccine and 5% having at least one single jab. The thinking is that in order to maintain a high enough level of herd immunity to prevent outbreaks, there needs to be 95% or more vaccination level.

Fleximum I see your summary of the main points from a different angle.

For clarity I have copied your post and added my reaction to it. For some reason I can't get the italics function to work so I hope this is clear!

1. Some people are concerned about childhood immunisations in general and the MMR in particular.

Ok don't have an issue with this.

1. The concerns are many and varied, but the most common one seems to be that of autism.

I think a lot of people concerned about vaccine safety tend to concerntrate on autism as it is the most political and mediaised aspect of the controversy and therefore attracts a lot of attention and research. There are many other concerns but we haven't discussed them here.

1. One paper, written by Dr Andrew Wakefield suggested a link between certain gut diseases, the MMR and autism. It looked at a very small group of affected children.

You make it sound like all the controversy is based on this one paper and the 12 children it examined. This now infamous paper was the beginning of public awareness through the media. However there has been research into a vaccine/autism link published before the Lancet paper and there has been a great deal since. This research takes many forms and examines many highly complex body mechanisms. Thousands of children have been examined. For example from the Thoughtful House website;

"A recent study at the MIND Institute at UC Davis looked at the response of dendritic cells to a brief exposure of minute amounts of thimerosal.58 Dendritic cells act in the immune system as antigen presenting cells, which means that they take a foreign molecule, package it, and present it for the T-cells (killer cells) in the immune system to recognize and deal with appropriately. The study demonstrated that these cells are extremely sensitive to thimerosal-induced damage, leading to cell death at higher concentrations and cell dysfunction at lower concentrations of thimerosal exposure.Thimerosal also affected the secretion of cytokines, which are the chemical messengers of the immune system, resulting in an immediate exaggerated response followed by chronic immune suppression. It was also clearly shown that it was the ethylmercury component of thimerosal that caused the damage. The results of this study are potentially important to further our understanding of the role of thimerosal in causing or contributing to the immune abnormalities seen in autistic children. The implication is that thimerosal may have damaged their immune system and prevented them from responding normally to viruses and other toxins. Interestingly, dendritic cells are the site where measles virus is normally found in tissue biopsies."

Goth, et al. Uncoupling of ATP-mediated calcium signaling and dysregulated IL-6 secretion in dendritic cells by nanomolar thimerosal. EHP online March 2006 doi:10.1289/ehp.8881

Here is a link to the actual study.

Here is a link to the body of research that supports Wakefield's hypothesis.

1. No further good quality studies seem to have been done looking at this link and its implications to the general population. There are other papers and vast amounts of discussion about this on the internet and there are multiple links on this discussion thread to those.

I totally disagree. There are many good quality studies that not only have looked for and found a potential link but an increasing body of evidence that examines and explains what the mechanisms are that make certain individuals suseptable to damage and describe in detail how that damage manifests. More research is needed in order to advance both treatment and prevention but the fundamentals are there already. Most of us on here may not be aware of this work or have read it but that doesn't mean that it doesn't exist. Put it this way, it won't make headline news in the mainstream press.

1. There have been a number of large population based studies which have so far shown no link between the MMR and autism. The quality of these studies have been debated at length on this thread.

OK.

1. The current UK position is that the MMR is safe and that single jabs expose children to a longer period without immunity to these diseases. Single jabs are available privately only and the going rate seems to be around £130 per shot.

OK although the wisdom of MMR vaccine over singles, even if it were to be safe, is deabated by specialists and poses ethical problems of the right to informed consent and choice of what is best for the individual in medical procedures. Rubella vaccination of infants to protect the wider population is a good example and measles vaccine is known to work better in older children anyway.

i do feel strongly that all girls should get a rubella jab at around 11, 12, instead of babies. The main reason is that rubella vaccine imnunity wears off [if have had real rubella which gives you life long immunity] so girls vaccinated as babies are actually more vulnerable to rubella as adults as very often they are no longer immune.

BTW thanks yurt1 for clarification on the 7% figure.

yes thanks yurt.

Wonk: Qally did apologise but the subtext remained that our opinions were not really worth reading as we aren't scientists, and that we were intolerant of other views. That stiffens the back a little, especially after being called self-righteous twats. There had been a largely measured tone until then.

Fleximum and other medics/scientists whose confidence in MMR and other vaccines remained undimmed, I would be really interested in your views on what has caused the increase in autism diagnoses.

Do you believe it is greater recognition of the condition? Do you perhaps believe that there has not been a real increase at all? Is there another environmental factor that you think comes into play?

Flexi and others: would really appreciate a response so am putting your names at the top of the post this time..

I'd be interested in the increase in rate as well stuffitlama. Obviously some - especially at the higher functioning end- is due to better dx. But the rate has increased enormously over the last 10- 20 years in ds1's SLD/PMLD school which caters for non-verbal and severely autistic children. These were not children who could have been missed.

There was a good article written by a father in the observer recently- he said we're better at recognising it now as there's so much more of it around. i think he could be right. I'll try and find the article

here we go This is autism as I know it btw. It was like reading about my life

oh and of course that's the type of autism that has increased so much in ds1's school over the last 10-20 years.

They're growing up now. New provision is being opened to meet the needs of this very needy population. "More will be opened" said the head of one residential unit 'because the numbers are so much greater than they were'. That unit costs £300 a day - the government should be desperate to know what is causing the rise and also just how big it is. Proper figures aren't even kept. It's a financial time bomb even if the needs of HFA/AS in adulthood continue to be ignored (as they are currently).

I too think there is more recognition, hence more diagnoses I think this accounts for the continued increases when vaccination levels have remained stable or fallen off. (Just a theory of mine trying to understand things.)

But there seems to be a very obvious real rise, which has triggered the trend of wider diagnoses. That ties in with the article you mention.

Didn't the government inquiry into autism ackowledge that there was a real rise, in addition to the wider diagnosis?

Also a Swedish study -- which went on an unsuccessful hunt for undiagnosed adult autistic people, specifically in psychiatric institutions.

Agree stuffit. I can understand better diagnosis of say AS, but children like ds1 just couldn't have been missed. I've spoken to people who were in ds1's school in the 80s and 90's and they are stunned when they see the classloads of kids with ASD now. These are children just like the boy in the article.

Agree with ruty about the Rubella.

Snickers - glad your ds is much better

Yurt1 what do you mean by this, could you clarify?;

"If you child has autism and an ulcerated gut chances are the NHS will no longer find it - so unless you pay you may well not know."

I'm intrigued by this cryptic statement. Thanks.

My ds caught measles at 14 months old, AFTER he had had the vacine.

Dss caught mumps at 15 AFTER he had had the vacine as well

Apologies not meant to be cryptic. I just meant with the break up of the Royal Free specialist unit (not sure of it's official name- but the team Wakefield was involved in) a real resource was lost. I know of children who were receiving treatment via the Royal Fee who were then refused further treatment for example. Also some of the children seen by that department were incredibly difficult to treat - and they just can't access the treatment now (for example ds1 needed an X-ray at our local large teaching hospital- they didn't manage to x-ray the bit they needed to do- his ankle - it would be very difficult to examine his colon unless a doctor had excellent skills- now most won't do it).

All the parents I know who have now had these sorts of investigations done since the banishment of Wakefield have been seen privately (unless they were able to see Murch on the NHS but he's on the GMC chopping block as well). Some of those children have been shown to have ulcerated guts, other's haven't. The Royal Free was getting a reputation for specialism in this area, now that's gone and hasn't really been replaced. That's what I meant.

Was that 15 years fizzbuzz? Was he OK- can be nasty in teens.

Anyone want to give me a precis of this thread????

Well, apparently because he was vaccinated it gave "some* protection, but it could have been much worse.

I thought all vaccines offered full protection, but I was obviously wrong
Once is a co-incidence, twice is a pattern....

Sorry haven't answered your query before. Boys now in bed so can concentrate. I think that a large part of the increase in cases of autism is due to better diagnosis. I have seen comments - can't remember if on this thread or others that suggest that not all of the increase in cases could be explained by this alone which I can't respond to as I haven't read the data.
The other possibility that immediately springs to mind is that childhood mortality is so much better now that many more children are living long enough to receive a diagnosis than would have done in the past.
If only 7% of cases of autism are caused by the MMR then clearly vaccinations alone cannot be causing the increase.

no vaccinations alone are certainly not responsible for the increase. However thimerosal I think was very probably a trigger, before it was taken out a few years ago. There are probably many other environmental and genetic triggers, again so much we don't know. The problem is that we need more research to find out.

"childhood mortality is so much better now that many more children are living long enough to receive a diagnosis"

Not really. Autism is said to rise not only because the number of autistic children is not higher, but because the rate of autistic children per thousand is on the rise.

Improvement in childhood mortality would increase population of both SN and autistic children, so the percentage of autistic/total would not increase just on this factor.

Fair enough. It was just a thought.